Comparison between CHA2DS2-VASc and the new R2CHADS2 and ATRIA scores at predicting thromboembolic event in non-anticoagulated and anticoagulated patients with non-valvular atrial fibrillation

BMC Cardiovascular Disorders

Research Article

Jose Ramón González-Juanatey¹  Rami Riziq-Yousef Abumuaileq¹  Andrea López-López¹  Sergio Raposeiras-Roubin¹  Javier García-Seara¹  Carlos Peña-Gil¹  Moisés Rodríguez-Mañero¹  Luis Martínez-Sande¹  Xesús Alberte Fernandez-López¹  Emad Abu-Assi¹ 

[1] Cardiology Department, University Clinical Hospital, A choupana s/n, 15706, Santiago de Compostela, Spain;

关键词: Atrial fibrillation;    Anticoagulant;    Thromboembolism;   

DOI  :  10.1186/s12872-015-0149-3

 received in 2015-08-30, accepted in 2015-11-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAccurate risk stratification is considered the first and most important step in the management of patients with non-valvular atrial fibrillation (NVAF). We compared the performance of the widely used CHA2DS2-VASc and the recently developed R2CHADS2 and ATRIA scores, for predicting thromboembolic (TE) event in either non-anticoagulated or anticoagulated patients with NVAF.MethodsThe non-anticoagulated cohort was comprised of 154 patients, whereas 911 patients formed the cohort of patients on vitamin-K-antagonist. The scores were computed using the criteria mentioned in their developmental cohorts. Measures of performance for the risk scores were evaluated at predicting TE event.ResultsIn the non-anticoagulated cohort, 9 TE events occurred during 11 ± 2.7 months. CHA2DS2-VASc showed significant association with TE occurrence: hazard ratio (HR) = 1.58 (95 % confidence interval [95 % IC] 1.01–2.46), but R2CHADS2 and ATRIA did not (HR = 1.23 (95 % CI 0.86–1.77) and 1.20 (95 % CI 0.93–1.56), respectively.In the anticoagulated cohort, after 10 ± 3 months of follow up, 18 TE events were developed. In that cohort, the three scores showed similar association with TE risk: HR = 1.49 (95 % CI 1.13–1.97), 1.41 (95 % CI 1.13–1.77) and 1.37 (95 % CI 1.12–1.66) for CHA2DS2-VASc, R2CHADS2 and ATRIA, respectively.In both cohorts, no TE event occurred in patients classified in the low risk category according to CHA2DS2-VASc or R2CHADS2.ConclusionsIn this study of NVAF patients, CHA2DS2-VASc has better association with TE events than the new R2CHADS2 and ATRIA risk scores in the non-anticoagulated cohort. CHA2DS2-VASc and R2CHADS2 can identify patients at truly low risk regardless of the anticoagulation status.

【 授权许可】

CC BY   
© Abumuaileq et al. 2015